Five years monitoring of lower urinary tract infections (LUTs) in nursing homes: Comparison of pathogens in diabetic and nondiabetic elderly subjects [Monitoraggio di cinque anni delle infezioni delle basse vie urinarie (IVU) nell'anziano in RSA: Confronto dei patogeni isolati nel soggetto anziano diabetico e non diabetico]
Ricci G.,RSA Villa San Clemente Villa Santa MI |
Barrionuevo M.L.,RSA Villa San Clemente Villa Santa MI |
Cosso P.,RSA Villa San Clemente Villa Santa MI |
Pagliari P.,RSA Villa San Clemente Villa Santa MI |
Ianes A.B.,Direzione Medica
Giornale di Gerontologia | Year: 2013
Urinary tract infections and asymptomatic bacteriuria are serious problems in diabetic patients even if many authors have not observed a difference in the prevalence of symptomatic or asymptomatic infections, or different uropathogens between subjects with and without diabetes mellitus. The purpose of this study was to ascertain what are, in elderly nursing home residents with diabetes, the most frequent pathogens of urinary tract infection or asymptomatic bacteriuria and if there were differences between diabetic (DM) and nondiabetic (noDM) patients. We performed an observational study by monitoring LUTs in elderly people living in RSA Villa San Clemente, a 110 beds nursing home (Villasanta, MB). During the 60 months of follow up, we collected urine specimens within the first 48 hours from the admission, in case of urinary symptoms or, in the absence of symptoms, whenever it was deemed necessary a control of blood chemistry (at least once every 6 months) and urinary culture were obtained. 718 positive urinary cultures (DM = in 104; noDM = 612) in 189 subjects (25 DM; 164 noDM) were recorded. Urinary tract infection were more frequent in women (with or without diabetes mellitus). Gram negative strains were the most frequently isolated without differences between diabetic and non diabetic subjects: Escherichia coli (noDM = 59.31% - DM = 57.69%), Proteus Mirabilis (noDM = 13.07%; DM = 9.62%), Klebsiella Pneumoniae (noDM = 8,5%; DM = 15.38%), Pseudomonas Aeruginosa (noDM = 4.24%; DM = 2.88%), Providencia Stuarti (noDM = 3.26%; DM = 0.96%), Enterobacter Aerogenes (noDM = 1.63%; DM = 0%) in our series, we documented a low prevalence of Gram-positive infections. Finally, in diabetic patients the occurrence of LUTs is more frequent than that of asymptomatic bacteriuria.